Intrapulmonary shunts in cyanotic congenital heart disease after surgical correction

Six children with surgically corrected cyanotic congenital heart disease were studied six months to four years after definitive repair. Five had tetralogy of Fallot, and 1 had severe valvular pulmonic stenosis with an atrial septal defect. The bronchial arteries were enlarged and tortuous in all, and intrapulmonary right to left shunts were demonstrated in 4 of the 6 cases. These shunts appear to reflect venous admixture rather than true anatomic connections between the bronchial and pulmonary circulations.